JOHN W MORTENSEN (NPI# 1023057130) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023057130 |
| Entity Type | Individual |
| Full Name | JOHN W MORTENSEN |
| Credential | M.D. |
| Practice Address |
2 W Fern Ave Redlands CA 92373-5916 |
| Mailing Address |
Po Box 2200 Redlands CA 92373-0722 |
| Practice Telephone | 9097933311 |
| Practice Fax Number | 9097964158 |
| Mailing Telephone | 9097933311 |
| Mailing Fax Number | 9097964158 |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
G15412 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G154122 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609315225 | John Mortensen | Behavioral Analyst | 175 Industrial Loop S, Orange Park, FL 32073-6217 | 2017-02-15 |
| 1982056552 | John Mortensen | Optometrist | 204 W Mariposa Rd, Suite 24, Nogales, AZ 85621-1007 | 2016-07-07 |
| 1164664439 | John Raymond Mortensen | Anesthesiology | 300 S Arlington Ave, Reno, NV 89501-2002 | 2009-04-01 |
| 1407802564 | John A Mortensen | Audiologist | 2255 S 108th St, West Allis, WI 53227-1107 | 2006-05-26 |
| Street Address |
2 W FERN AVE |
| City | REDLANDS |
| State | CA |
| Zip Code | 92373-5916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518962802 | Sue Allison Field | Anesthesiology | 2 W Fern Ave, Redlands, CA 92373-5916 | 2005-06-14 |
| 1114535044 | Jose Lopez | Nurse Practitioner | 2 W Fern Ave, Redlands, CA 92373-5916 | 2020-07-16 |
| 1275158305 | Carley Marie Anderson | Physician Assistant | 2 W Fern Ave, Redlands, CA 92373-5916 | 2020-06-15 |
| 1194387373 | Timothy Michael Taylor | Nurse Practitioner | 2 W Fern Ave, Redlands, CA 92373-5916 | 2019-07-08 |
| 1083180392 | Janet Cantada | Pharmacist | 2 W Fern Ave, Redlands, CA 92373 | 2018-10-15 |
| 1821579335 | Jacqueline Hae Yun Evans | Physician Assistant | 2 W Fern Ave, Redlands, CA 92373-5916 | 2018-08-22 |
| 1063907152 | Kristen Nicole Chaves | Nurse Practitioner | 2 W Fern Ave, Redlands, CA 92373-5916 | 2018-06-29 |
| 1154823177 | Angela Joan Flores | Pharmacist | 2 W Fern Ave, Redlands, CA 92373 | 2018-03-06 |
| 1619482718 | Agnes Arorong Esteva | Hospitalist | 2 W Fern Ave, Redlands, CA 92373 | 2017-12-12 |
| 1578075867 | Lisa Gilbert | Nurse Practitioner | 2 W Fern Ave, Redlands, CA 92373-5916 | 2017-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473422 | Mindfulness Counseling Services | Marriage & Family Therapist | 101 E. Redlands, Suite 170a, Redlands, CA 92373 | 2020-09-24 |
| 1710596721 | Vandna Mittal | Counselor | 26967 Beamount Avenue, 1020 Coronado Drive, Redlands, CA 92373 | 2020-07-26 |
| 1164062345 | Sara Bencoe | Nurse Practitioner | 101 E. Redlands Blvd. Ste. 106, Redlands, CA 92373 | 2020-01-15 |
| 1033604103 | John Duane Wuchenich | Anesthesiology | 451 Summit Avenue, Redlands, CA 92373 | 2018-06-29 |
| 1013401074 | Adept Hospice Care | Hospice Care, Community Based | 515 New Jersey St., Suite G, Redlands, CA 92373 | 2018-06-21 |
| 1134616121 | Rodrigo Robles | Student in an Organized Health Care Education/Training Program | 26001 Redlands Blvd ., 2nd Floor, 2d 301, Redlands, CA 92373 | 2018-04-16 |
| 1760987614 | Redlands Endodontics | Dentist | 245 Terracina Blvd Suite 207 B, Redlands, CA 92373 | 2018-03-23 |
| 1487164166 | Tyler Stafford | Behavioral Analyst | 1467 Ford St. Suite 104, Redlands, CA 92373 | 2017-10-06 |
| 1083131486 | Shannon Palmowski | Behavioral Analyst | Institute for Behavioral Health, 1041 Alabama Ave, Redlands, CA 92373 | 2017-08-25 |
| 1275062622 | Erim Sarbuland | Marriage & Family Therapist | 101 East Redlands Boulevard, Suites #215, Redlands, CA 92373 | 2017-06-08 |
| Find all providers in zip 92373 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710518535 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 107, Redlands, CA 92373-4230 | 2020-01-30 |
| 1164053286 | Health Diagnostics of California A Professional Corporation | Radiology | 1690 Barton Rd Ste 108, Redlands, CA 92373-4230 | 2020-01-28 |
| 1700252467 | Riverside Radiology Medical Group, Inc. | Radiology | 30700 E Sunset Dr S, Redlands, CA 92373-7448 | 2015-08-18 |
| 1023255031 | Loma Linda University Radiology Medical Group, Inc. | Radiology | 26780 Barton Road, Redlands, CA 92373-4308 | 2009-01-13 |
| 1144437559 | Charlene Larsen Andersen | Radiology | 762 Hilary Ln, Redlands, CA 92373-5618 | 2007-05-16 |
| 1023043551 | Pacific West Specialties, LLC | Radiology | 101 E Redlands Blvd Ste 212, Redlands, CA 92373-4724 | 2006-07-12 |
| 1588697924 | Shailendri Eswar-rao Philip | Radiology | 518 S Buena Vista St, Redlands, CA 92373-5804 | 2006-07-09 |
| 1528005188 | Susan Spieller | Radiology | 608 E Sunset Dr N, Redlands, CA 92373-6451 | 2006-06-01 |
| 1417904368 | Szabolcs S Mera | Radiology | 2 W. Fern Ave, Redlands, CA 92373-5916 | 2006-05-27 |
| 1043267156 | Kerry D Rold | Radiology | 2 West Fern Ave, Redlands, CA 92373-5916 | 2006-05-27 |
| Find all providers in REDLANDS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.